Transferability of principles of evidence based medicine to improve educational quality: systematic review and case study of an online course in primary health care.
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ABSTRACT:
SUBMITTER: Greenhalgh T
PROVIDER: S-EPMC140008 | biostudies-literature | 2003 Jan
REPOSITORIES: biostudies-literature
Publications
Transferability of principles of evidence based medicine to improve educational quality: systematic review and case study of an online course in primary health care.
Greenhalgh Trisha T Toon Peter P Russell Jill J Wong Geoff G Plumb Liz L Macfarlane Fraser F
BMJ (Clinical research ed.) 20030101 7381
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Project description:Despite the importance of data literacy skills for academic and professional careers, learning these skills is a source of stress and difficulty for undergraduate students. This study first introduces an online supplemental instruction resource to support student learning in an introductory data analysis course at a large public university. To evaluate its impact, we conduct a pre-registered double-blind within-subject experiment. Each student is randomly assigned to a subset of the online supplemental instruction modules and takes an exam assessing concepts covered by the course material and supplemented by the modules. Access to the online supplemental instruction modules improves student performance on exam questions, and students who engage with the modules improve exam scores even more. We find no differential impacts based on pre-treatment GPA or underrepresented status, and a post-experiment survey suggests that the online supplemental instruction modules are also well-received by students. This study shows that asynchronous online supplemental instruction resources are a promising way to support student learning in data literacy.
| S-EPMC11658515 | biostudies-literature
Project description:BackgroundOnline education has experienced explosive growth, particularly in the wake of the COVID-19 pandemic. We explored the current state of the evidence base for online education targeted towards healthcare professionals working in pediatric intensive care units (PICUs), to report how we are using online education in our field.Materials and methodsWe performed a literature review by systematically generating a list of publications indexed in PubMed describing online educational interventions in the PICU, using Medical Subject Header (MeSH)-based search terms and the following inclusion criteria: studies published after 2005 that describe online educational interventions aimed at healthcare professional working in the PICU. We reviewed the full text of all included articles, and summarized the study aims, design, and results.ResultsOur initial search yielded 1,071 unique articles. After screening abstracts and titles, then full texts, eight articles were included in the review. Many online learning modalities are represented, including websites, self-study modules, videos, videoconferencing, online self-assessment with feedback, virtual patient cases, screen-based simulation, and podcasts. Three studies focused on residents, two studies on nurses, two studies on a multidisciplinary team, and one study on transport nurses and paramedics. Most studies utilized participant surveys to assess satisfaction, and half included pre- and post-intervention multiple-choice question tests. Only one study included a patient-related outcome measure.ConclusionsDespite growth in online medical educational intervention research, there are relatively few published studies in pediatric critical care, and only one study evaluated the impact of online learning on patient outcomes. There remain significant opportunities for PICU educators to assess the impact of online educational interventions, especially related to clinician behaviors and patient outcomes.
| S-EPMC10033549 | biostudies-literature
Project description:Students' academic achievement is a major concern among countries. Governments spent a lot of money on education to improve students' competences at all levels of education. Despite the enormous amount of money invested and the reforms made to curricula in many countries in recent years, these measures are not generally producing the desired results according to the data of International Performance Measurement programs for students (e.g., Program for International Student Assessment-PISA by OECD). Given the importance of this issue, this article presents an instructional-motivational model developed in the last decade to explain and improve students' learning outcomes, e.g., academic achievement and course satisfaction, entitled the "The Educational Situation Quality Model" (MOCSE, acronym in Spanish). Unlike other educational models, MOCSE offers an integrative teaching-learning approach to explain learning outcomes. By taking the educational setting as a unit of analysis, this proposal introduces a new perspective into the existing literature to predict students' achievement and course satisfaction by combining contributions from relevant psycho-educational theories, such as: "The Job Demands-Resources Model," "The Expectancy-Value Theory," and "The Achievement Goal Theory." Besides being a conceptual framework to guide research, it also provides a methodological way to improve teacher practice and learning outcomes. In this article we first briefly explain the main model's characteristics and functioning from the student perspective and, second, based on the MOCSE, we offer some keys for teachers to improve academic achievement and students' course satisfaction for a specific curricular subject. Finally, future proposals and challenges are discussed. Questionnaires are provided in the Annex.
| S-EPMC6657589 | biostudies-literature
Project description:BackgroundEvidence-based medicine (EBM) is critical for providing the best scientifically proven patient health care, and it is implemented worldwide in order to improve the quality of the delivered health care. However, not all Syrian health professionals are knowledgeable about the importance, methodology, and implementation of EBM. Providing web-based learning courses on EBM might be effective in improving the EBM knowledge of health care professionals.ObjectiveThis study was performed to test the effectiveness and the feasibility of an asynchronous web-based course on EBM in improving the competencies of Syrian health care professionals in terms of EBM.MethodsA web-based course on EBM was developed in Arabic and uploaded onto the Syrian Virtual University platform. An electronic registration form was designed and distributed to medical groups on social media for registration to this web-based course. Both the pretest and posttest had the same 3 sections to measure the impact of this web-based EBM program on the knowledge, skills, and attitudes of the Syrian health care professionals. The posttest had an additional section for measuring the efficacy and ease of use of this program. Student paired 1-tailed t test was used to analyze the differences in the different assessment sections among the participants.ResultsNineteen participants filled the electronic registration form, but 8 participants did not meet the inclusion criteria. Therefore, the pretest was sent to the remaining 11 participants (7 men and 4 women) who graduated from Syrian universities. Ten of them completed the pretest, while 7 of them completed the posttest. The web-based course was found to be effective in improving the participants' EBM knowledge, skills, and attitudes at P>.05. Further, the web-based EBM course was feasible and easy-to-use.ConclusionsIn order for EBM to be implemented in Syria, continuous medical education training programs should be designed for clinical practitioners. Our study shows that asynchronous web-based medical education is an effective and a feasible means for introducing the concept of EBM, improving practitioners' skills, and promoting the positive attitudes of Syrian clinical practitioners toward EBM.
| S-EPMC9644249 | biostudies-literature
Project description:Recent studies suggest US medical schools are not effectively addressing musculoskeletal medicine in their curricula. We examined if there were specific areas of weakness by analyzing students' knowledge of and confidence in examining specific anatomic regions. A cross-sectional survey study of third- and fourth-year students at Harvard Medical School was conducted during the 2005 to 2006 academic year. One hundred sixty-two third-year students (88% response) and 87 fourth-year students (57% response) completed the Freedman and Bernstein cognitive mastery examination in musculoskeletal medicine and a survey eliciting their clinical confidence in examining the shoulder, elbow, hand, back, hip, knee, and foot on a one to five Likert scale. We specifically analyzed examination questions dealing with the upper extremity, lower extremity, back, and others, which included more systemic conditions such as arthritis, metabolic bone diseases, and cancer. Students failed to meet the established passing benchmark of 70% in all subgroups except for the others category. Confidence scores in performing a physical examination and in generating a differential diagnosis indicated students felt below adequate confidence (3.0 of 5) in five of the seven anatomic regions. Our study provides evidence that region-specific musculoskeletal medicine is a potential learning gap that may need to be addressed in the undergraduate musculoskeletal curriculum.
| S-EPMC2584311 | biostudies-other
Project description:BackgroundMedical education is a cornerstone in the global combat against diseases such as diabetes and obesity which together affect more than 500 million humans. Massive Open Online Courses (MOOCs) are educational tools for institutions to teach and share their research worldwide. Currently, millions of people have participated in evidence-based MOOCs, however educational and professional benefit(s) for course participants of such initiatives have not been addressed sufficiently. We therefore investigated if participation in a 6 week open online course in the prevention and treatment of diabetes and obesity had any impact on the knowledge, skills, and career of health care professionals contrasting participants from developing countries versus developed countries.Methods52.006 participants signed up and 29.469 participants were active in one of the three sessions (2014-2015) of Diabetes - a Global Challenge. Using an online based questionnaire (nine sections) software (Survey Monkey), email invitations were send out using a Coursera based database to the 29.469 course participants. Responses were analyzed and stratified, according to the United Nations stratification method, by developing and developed countries.Results1.303 (4.4%) of the 29.469 completed the questionnaire. 845 of the 1303 were defined as health care professionals, including medical doctors (34%), researchers (15%), nurses (11%) and medical students (8%). Over 80% of the health care participants report educational benefits, improved knowledge about the prevention and treatment therapies of diabetes and furthermore improved professional life and practice. Over 40% reported that their professional network expanded after course participation. Study participants who did not complete all modules of the course reported similar impact as the ones that completed the entire course(P = 0.9). Participants from developing countries gained more impact on their clinical practice (94%) compared to health care professionals from developed regions (88%) (Mean of differences = 6%, P = 0.03.ConclusionsBased on self-reports from course participants, MOOC based medical education seems promising with respect to providing accessible and free research-based education to health professionals in both developing and developed countries. Course participants from developing countries report more benefits from course participation than their counterparts in the developed world.
| S-EPMC5452380 | biostudies-literature
Project description:PurposeTo evaluate feasibility and impact of evidence-based medicine (EBM) educational prescriptions (EPs) in medical student clerkships.MethodsStudents answered clinical questions during clerkships using EPs, which guide learners through the "four As" of EBM. Epidemiology fellows graded EPs using a rubric. Feasibility was assessed using descriptive statistics and student and fellow end-of-study questionnaires, which also measured impact. In addition, for each EP, students reported patient impact. Impact on EBM skills was assessed by change in EP scores over time and scores on an EBM objective structured clinical exam (OSCE) that were compared to controls from the prior year.Results117 students completed 402 EPs evaluated by 24 fellows. Average score was 7.34/9.00 (SD 1.58). 69 students (59%) and 21 fellows (88%) completed questionnaires. Most students thought EPs improved "Acquiring" and "Appraising". Almost half thought EPs improved "Asking" and "Applying". Fellows did not value grading EPs. For 18% of EPs, students reported a "change" or "potential change" in treatment. 56% "confirmed" treatment. EP scores increased by 1.27 (95% CI: 0.81-1.72). There were no differences in OSCE scores between cohorts.ConclusionsIntegrating EPs into clerkships is feasible and has impact, yet OSCEs were unchanged, and research fellows had limitations as evaluators.
| S-EPMC5866052 | biostudies-literature
Project description:Education in quality improvement (QI) is endorsed by the Association of American Medical Colleges across the spectrum of undergraduate, graduate, and postgraduate training. QI training is also a required component of graduate medical training per the American College of Graduate Medical Education. Despite widespread recognition of the importance of QI education and high levels of trainee involvement in QI as reported by pulmonary and critical care fellowship program directors, significant barriers to the implementation of effective and meaningful QI education during training exist. This creates an opportunity for the promotion of successfully implemented QI programs. Research demonstrates that successful QI educational programs involve the teaching of key QI concepts, participation in QI projects, protected time for QI project development, and institutional support. Using QI models such as the Plan-Do-Study-Act cycle and the Standards for Quality Improvement Reporting Excellence framework for reporting new knowledge about healthcare improvements also enhances both the educational value of the QI project and prospects for wider scholarly dissemination. In this perspective article, three examples of QI projects are discussed that serve to illustrate effective strategies of QI implementation.
| S-EPMC8043285 | biostudies-literature
Project description:Today's computational researchers are expected to be highly proficient in using software to solve a wide range of problems ranging from processing large datasets to developing personalized treatment strategies from a growing range of options. Researchers are well versed in their own field, but may lack formal training and appropriate mentorship in software engineering principles. Two major themes not covered in most university coursework nor current literature are software testing and software optimization. Through a survey of all currently available Comprehensive R Archive Network packages, we show that reproducible and replicable software tests are frequently not available and that many packages do not appear to employ software performance and optimization tools and techniques. Through use of examples from an existing R package, we demonstrate powerful testing and optimization techniques that can improve the quality of any researcher's software.
| S-EPMC7924430 | biostudies-literature
Project description:BackgroundWith the rapid proliferation of online medical education resources, quality evaluation is increasingly critical. The Medical Education Translational Resources: Impact and Quality (METRIQ) study evaluated the METRIQ-8 quality assessment instrument for blogs and collected feedback to improve it.MethodsAs part of the larger METRIQ study, participants rated the quality of five blog posts on clinical emergency medicine topics using the eight-item METRIQ-8 score. Next, participants used a 7-point Likert scale and free-text comments to evaluate the METRIQ-8 score on ease of use, clarity of items, and likelihood of recommending it to others. Descriptive statistics were calculated and comments were thematically analyzed to guide the development of a revised METRIQ (rMETRIQ) score.ResultsA total of 309 emergency medicine attendings, residents, and medical students completed the survey. The majority of participants felt the METRIQ-8 score was easy to use (mean ± SD = 2.7 ± 1.1 out of 7, with 1 indicating strong agreement) and would recommend it to others (2.7 ± 1.3 out of 7, with 1 indicating strong agreement). The thematic analysis suggested clarifying ambiguous questions, shortening the 7-point scale, specifying scoring anchors for the questions, eliminating the "unsure" option, and grouping-related questions. This analysis guided changes that resulted in the rMETRIQ score.ConclusionFeedback on the METRIQ-8 score contributed to the development of the rMETRIQ score, which has improved clarity and usability. Further validity evidence on the rMETRIQ score is required.
| S-EPMC6795360 | biostudies-literature